| NPI | 1265418529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP3320) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS R860324) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2011-07-15 |